Landmark Proposed Rule Outlines Future For Our Health Care System

The Centers for Medicare and Medicaid Services (CMS) recently released their proposed rule implementing provisions of the Medicare Access and CHIP Reauthorization Act (MACRA). The proposal lays out CMS’ vision for the new Merit-Based Incentive Payment System (MIPS), which will replace the current quality programs (PQRS, the Value Modifier and the Meaningful Use program) as required by the MACRA legislation . The proposed rule also outlines details regarding Alternative Payment Models (APMs). Certain qualifying APM participants will be eligible for 5 percent bonus payments in 2019-2024 and will be exempt from the MIPS program.

Part of the proposed restructuring of the current quality programs involves major changes to the EHR Incentive/Meaningful Use program, which will sunset in 2019. Instead, beginning in 2019 the MIPS program will incorporate the “advancing care information” performance category to address use of EHR technology to advance care, with an emphasis on interoperability and information exchange. CMS states this category will not include an all-or-nothing scoring currently utilized in the Meaningful Use program.

The North Carolina Medical Society (NCMS) is reviewing the 962-page proposal, and will update this webpage with additional information about the MIPS and APM proposals shortly. The AMA also has updated their MACRA website with additional materials to assist physicians with the changes resulting from this landmark legislation. Be sure to visit our MACRA webpage and the Quality Blog often for updates!